The obesity epidemic in the U.S. is a major health issue and it’s getting worse. Almost half of American adults are projected to be obese, not just overweight, by 2030, according to Harvard researchers estimates published in December 2019 in the New England Journal of Medicine.
While the country is facing an obesity crisis, the problem is much more pronounced in certain places within the U.S.
The most obese county in Florida is Gadsden, which has a population of 45,945. About 43.5% of adult residents are obese, compared to 27.2% in the state as a whole.
There are a multitude of social and economic factors that predispose certain populations to reporting higher obesity rates. With obesity increasing the risk of several serious health conditions, including diabetes, heart disease, and certain cancers, a high obesity rate can detrimentally affect the health and life expectancy of a population. In Gadsden County, 26.8% of residents report being in poor or fair health, and 20.5% have been diagnosed with diabetes. The statewide figures are 19.5% and 10.8%, respectively.
Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem among Americans, among them a sedentary lifestyle. About 35.3% of Gadsden County’s adult residents don’t exercise regularly, compared to 25.8% in Florida.
Many of the counties with high adult obesity rates also tend to have low-income populations. People with lower incomes are less able to afford appropriate health care and healthy lifestyles, which include eating a healthy diet and having easy access to gyms and other options for physical activity. The median annual household income in Gadsden County is $41,401 a year, which is $14,259 less than the Florida median income of $55,660 a year.
To identify the most obese county in each state, 24/7 Wall St. reviewed county-level health data from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. Obesity rate is the share of adult residents who report a body mass index of 30 or greater. These are the most obese counties in every state.
| State | County | Adult obesity rate | Median household income | Adults in poor or fair health | Adults who don’t exercise | Largest place in county |
|---|---|---|---|---|---|---|
| Alabama | Macon | 50.9% | $33,370 | 28.0% | 32.5% | Tuskegee |
| Alaska | Aleutians East | 51.9% | $69,250 | 20.9% | 26.6% | Sand Point |
| Arizona | Yuma | 37.9% | $45,243 | 26.1% | 24.3% | Yuma |
| Arkansas | St. Francis | 48.2% | $35,348 | 31.4% | 31.0% | Forrest City |
| California | Colusa | 39.0% | $59,401 | 24.2% | 26.2% | Colusa |
| Colorado | Logan | 36.0% | $53,318 | 17.6% | 22.3% | Sterling |
| Connecticut | Windham | 31.0% | $66,550 | 15.5% | 24.0% | Willimantic |
| Delaware | Kent | 38.4% | $60,910 | 21.0% | 30.9% | Dover |
| Florida | Gadsden | 43.5% | $41,401 | 26.8% | 35.3% | Quincy |
| Georgia | Candler | 53.7% | $33,736 | 28.1% | 28.1% | Metter |
| Hawaii | Hawaii | 25.8% | $62,409 | 17.1% | 19.9% | Hilo |
| Idaho | Owyhee | 40.2% | $43,798 | 24.4% | 26.6% | Homedale |
| Illinois | Vermilion | 43.2% | $46,515 | 21.1% | 29.0% | Danville |
| Indiana | Martin | 45.8% | $52,726 | 20.0% | 39.0% | Loogootee |
| Iowa | Wayne | 48.6% | $44,768 | 17.7% | 27.8% | Corydon |
| Kansas | Osage | 42.4% | $54,090 | 17.7% | 30.1% | Osage City |
| Kentucky | Owsley | 46.7% | $30,284 | 30.5% | 27.4% | Booneville |
| Louisiana | Sabine | 50.8% | $40,336 | 23.9% | 33.2% | Many |
| Maine | Aroostook | 37.7% | $41,123 | 21.7% | 30.7% | Presque Isle |
| Maryland | Somerset | 41.9% | $37,803 | 23.8% | 32.5% | Princess Anne |
| Massachusetts | Hampden | 30.5% | $55,429 | 19.1% | 26.1% | Springfield |
| Michigan | Gratiot | 45.6% | $47,848 | 20.7% | 23.0% | Alma |
| Minnesota | Marshall | 43.5% | $60,118 | 14.6% | 29.1% | Warren |
| Mississippi | Sunflower | 53.7% | $30,838 | 32.4% | 31.0% | Indianola |
| Missouri | Dunklin | 41.7% | $36,380 | 29.2% | 42.9% | Kennett |
| Montana | Hill | 39.3% | $49,321 | 20.1% | 27.9% | Havre |
| Nebraska | Thurston | 47.2% | $51,034 | 23.5% | 29.2% | Pender |
| Nevada | Pershing | 39.2% | $50,491 | 21.8% | 28.4% | Lovelock |
| New Hampshire | Coos | 36.7% | $47,117 | 18.5% | 26.2% | Berlin |
| New Jersey | Salem | 39.0% | $66,842 | 19.0% | 32.6% | Pennsville |
| New Mexico | Guadalupe | 39.6% | $24,798 | 23.6% | 28.9% | Santa Rosa |
| New York | Chenango | 39.3% | $52,002 | 17.6% | 24.2% | Norwich |
| North Carolina | Bladen | 49.1% | $36,173 | 26.2% | 30.7% | Elizabethtown |
| North Dakota | Rolette | 45.5% | $43,158 | 28.6% | 32.6% | Belcourt |
| Ohio | Jackson | 42.8% | $47,550 | 22.5% | 35.0% | Jackson |
| Oklahoma | Okfuskee | 58.9% | $38,411 | 28.5% | 42.4% | Okemah |
| Oregon | Malheur | 39.9% | $43,313 | 26.0% | 23.0% | Ontario |
| Pennsylvania | Armstrong | 44.0% | $51,410 | 18.7% | 34.0% | Kittanning |
| Rhode Island | Kent | 30.4% | $73,521 | 15.4% | 23.4% | Warwick |
| South Carolina | Union | 46.8% | $41,186 | 22.8% | 33.0% | Union |
| South Dakota | Ziebach | 52.5% | $37,400 | 30.5% | 27.2% | Eagle Butte |
| Tennessee | Lauderdale | 47.4% | $39,896 | 30.2% | 36.0% | Ripley |
| Texas | Burleson | 46.6% | $57,731 | 21.1% | 27.4% | Caldwell |
| Utah | San Juan | 38.5% | $45,394 | 25.4% | 23.0% | Blanding |
| Vermont | Franklin | 34.9% | $65,485 | 14.1% | 26.1% | St. Albans |
| Virginia | King and Queen | 48.7% | $63,982 | 21.4% | 32.2% | N/A |
| Washington | Pend Oreille | 41.6% | $50,591 | 18.8% | 27.7% | Newport |
| West Virginia | McDowell | 44.9% | $27,682 | 36.5% | 36.0% | Welch |
| Wisconsin | Columbia | 45.7% | $68,005 | 14.4% | 25.1% | Portage |
| Wyoming | Weston | 37.2% | $57,031 | 16.9% | 25.5% | Newcastle |
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